Pain-killer caution for early pregnancy

WOMEN trying to conceive or who are in the early stages of
pregnancy should be cautious about their use of over-the-counter
pain-killers, an Australian gynaecologist warns.

Research has shown women may be increasing their chances of
miscarriage by taking non-steroidal anti-inflammatory drugs
(NSAIDs) such as ibuprofen and aspirin, particularly around the
time of conception, according to Michael Cooper of the University
of Sydney.

He said women sometimes took drugs such as ibuprofen and
naproxen to relieve what they perceived as period pain when they
were actually pregnant.

The study found no association between paracetamol use and
increased miscarriage risk.

"If you're using aspirin and this class of drugs in that early
pregnancy period, you may well be increasing your risk of
miscarriage," said Dr Cooper, the head of general gynaecology at
Sydney's Royal Prince Alfred Hospital. "If you're in the situation
where you're wanting to get pregnant, then you very much need to be
reassessing your use of analgesics."

He said a recent international literature review of the use of
NSAIDs for endometriosis, which affects up to 15 per cent of women
in the reproductive years and causes severe period pain, found no
conclusive evidence that they were effective in alleviating the
pain. Endometriosis  when womb-lining tissue grows outside
the uterus and attaches to other organs  can make it
difficult for women to conceive. If they used NSAIDs to relieve the
pain, that might compound the problem, Dr Cooper said.

A 2003 study of more than 1000 pregnant women published in the
British Medical Journal, found 53  or 5 per cent of
the sample  reported NSAID use around conception or during
pregnancy.

Even after adjusting for factors such as previous miscarriage,
education, maternal age, race, vitamin use and smoking, researchers
found that those who used NSAIDs had an 80 per cent increased risk
of miscarriage. The association was stronger in women who took
NSAIDs about the time of conception or used the medications for
more than a week.

"I wouldn't like to be overly dramatic about it. I'd be keen not
to alarm people," Dr Cooper said.

"We probably need a few more studies to be definitive about
this. But at the end of the day there's probably going to be
something to this story and if you're planning to get pregnant you
should be careful in your choice of analgesics."

Dr Cooper said most women, and even many gynaecologists, were
unaware of the potential problem.

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